Background The dispensation of enteral nutrition (EN) to institutionalised patients has recently being carried from the hospital pharmacy services corresponding to the health area. Hospital pharmacists can provide the development of pharmaceutical care to these patients in terms of EN, and it suppose a cost saving at the same time.
Purpose To identify and analyse the indication, nutritional status and use of EN in institutionalised patients, and quantify the economic impact since the beginning of the dispensation from the hospital pharmacy.
Material and methods Observational and multicentre study including institutionalised patients receiving EN dispensed from the hospital pharmacy. Data analysed: age, sex, pathology, nutritional status, type of EN, use as supplement and route of administration. Cost differences were calculated by dispensing from the community pharmacy or from the hospital pharmacy, considering only the costs of EN, and convenience to patients having to transport the EN from the hospital rather than from a community pharmacy.
Results 371 institutionalised patients were analysed in 4 centres. 8.09% (30) were treated with EN. Mean age was 82 and 66.66% (20) were women. Pathologies for prescribing were degenerative neurological disorders in 60% (18), 26.66% (8) stroke and 13.33%(4) other diagnostics. Regarding nutritional status, 40% (12) had mild malnutrition and 20% (6) severe. Normoproteic and high caloric with fibre was the predominant diet in 36.66% (11) of patients, followed by high protein and high caloric with fibre 16.66% (5), high protein and high caloric 13.33% (4), normoproteic and normocaloric with fibre 10% (3), high protein and normocaloric for hyperglycaemic syndromes 10% (3) and other in 13.33% (4). In 63.33% (19) EN was used as a supplement and in 36.66% (11) as the complete diet. In 63.33% (19) administration was orally, in 23.77% (7) through percutaneous gastrostomy and in 13.33% (4) through a nasogastric tube. The economic impact dispensing from the community pharmacy would have been 162.526€. However, dispensing from hospital was 50.471€, achieving a saving of 112.055€ with an average of 3.735€ per patient.
Conclusion EN most used was normoproteic high caloric with fibre as an oral supplement. Pathology with increased spending was degenerative neurological disorders. Dispensing EN for institutionalised patients from the hospital pharmacy supposes an increase in the burden of care and significant savings for the health system.
No conflict of interest.
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